APMs and BPCI Advanced: What They Mean for Orthopaedists

Andrea Leyton-Mange, BA; John P. Andrawis, MD, MBA; Karl Koenig, MD, MS

Several new payment models have been introduced under the Medicare Access and CHIP Reauthorization Act (MACRA). The most common is the Merit-Based Incentive Payment System (MIPS), which requires providers to report directly on performance measures including outcomes, cost, and operational data. Performance on these metrics, as well as how much data the clinician reports, determine the reimbursement adjustment with a maximum of +/- 4 percent to start, increasing to +/- 9 percent in 2022.

Are Physicians Required to Return Overpayments?

Michael R. Marks, MD, MBA; Michael J. Sacopulos, JD

When overpaid, many providers wonder if they need to return the funds. The short answer is yes. An overpayment is money that does not belong to providers and keeping it exposes them to collection and other risks. The U.S. Centers for Medicare & Medicaid Services (CMS) ruled that Medicare overpayments must be refunded within 60 days. However, some practices are passive on the issue and many do not have a policy addressing these funds.

7 Secrets to Increasing Leadership Impact

Brian Braudis

A major concern for senior executives is “bench strength”—the quantity and quality of up-and-coming, potential leaders who are in the pipeline. The problem is that too often these would-be leaders “hold back, shrink, and play small.” In today’s climate of unprecedented change, intense competition, and more demanding customers, leaders can’t hold back or shrink.

ASCs and Hospitals Yield Similar Outcomes for Treatment of Supracondylar Humerus Fractures

Terry Stanton

A study of pediatric patients treated surgically for supracondylar humerus (SCH) fractures found that those who were treated in an ambulatory surgical center (ASC) received care that was as safe, faster, and more cost-effective than those treated in a children’s hospital. The study, presented at the AAOS 2018 Annual Meeting by Carson Mills Rider, MD, identified 316 patients who underwent closed reduction and percutaneous pinning (CRPP) of Gartland extension type II SCH fractures.